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The Pulse (News)

BANGOR, Maine — Since 2007, Eastern Maine Medical Center has been developing and refining its patient blood management program in a successful bid to decrease the need for blood transfusions. This week, medical experts from Western Australia are in Bangor, taking notes on how to implement a similar program at hospitals there. “The world is about to change from blood transfusion to patient blood management,” said Axel Hofmann, a consultant for the Western Australia Department of Health, and EMMC is “almost at the center of the patient blood management universe.”
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The WA health system will become the first in the world to adopt a "bloodless surgery" policy that could significantly reduce the use of blood transfusions and save the State tens of millions of dollars.

The pioneering approach, known as patient blood management, is used at Fremantle Hospital - reducing its use of blood - and will be rolled out across all hospitals.

Experts say it is safer for patients and will help avoid a looming shortage of blood as more people have cancer and orthopaedic surgery.

Under the program, patients going into hospital for surgery will have a blood test several weeks before to check if they need therapy such as iron supplements to treat anaemia. Doctors will also be encouraged to use surgical techniques that minimize blood loss.
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Doctors at The Alfred brought Tamara Coakley, 33, back from the brink of death after a horrific car crash left her with severe blood loss and dangerously close to heart failure. This was the first reported case of the synthetic blood reversing cardiac hypoxia and anaemia in a trauma patient.
A last-ditch effort to save Mrs Coakley's life led to 10 units of the haemoglobin-based oxygen carrier, called HBOC-201 to be flown in from the US.
It contains a molecule derived from cow's blood and restored the level of haemoglobin in her blood, which carries oxygen to the tissues.
Trauma service director Dr Mark Fitzgerald said it marked an important step in developing a viable blood alternative to address world blood supply shortages.
Unlike donor blood it does not require matching and can be stored without refrigeration for up to three years- making it suitable for use in a rural settings or on the battlefield.
"It's a bit of science fiction," Dr Fitzgerald said.
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Celina Ortiz (left) watches as her daughter, 13-year-old Tania, examines a model of a spine with metal supports similar to the type she received recently during a 'bloodless surgery' at Legacy Emanuel Medical Center in North Portland. The type of surgery was important to the Ortiz family because they are Jehovah's Witnesses.Severe scoliosis created such curvature in 13-year-old Tania Ortiz's spine that she hunched over, putting pressure on her heart and lungs. Although the problem could be corrected by implanting two metal rods along her spine, surgeons throughout Kansas refused because of her family's religious beliefs. Devout Jehovah's Witnesses, such as the Ortiz family, interpret a Bible passage as a commandment to abstain from blood transfusions, or even storing the patient's own blood in advance so it could later be used.
Knowing those restrictions -- and believing that transfusions would likely be needed during the long and complicated surgery -- doctors would not operate. So in late 2010, the family reached out to Witness elders in their hometown of Olathe, a city about 20 miles southwest of Kansas City.
"We asked God for help," said her father, Santiago Ortiz. "We prayed for good hands."
The answer came when officials at the Jehovah's Witness headquarters in New York City told them to go to Portland's Legacy Health, which 20 years ago started the nation's first large-scale, hospitalwide bloodless surgery program.
Hospitals in other cities around the country have started similar programs. But Legacy's Bloodless Surgery and Medicine Program is so well known and established that thousands of Witnesses come to Portland each year from across the country as well as from overseas.
What the program does is manage blood loss -- before and during an operation. The techniques and procedures are covered by the patient's insurance. And because of lower costs, infection rates and shorter hospital stays, the hospital and patient save money.
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